Press Release FOR IMMEDIATE RELEASE:CONTACT: Roseanne Pawelec, Tuesday, July 23, 2002(617) NEARLY HALF OF ALL MASSACHUSETTS RESIDENTS OVERWEIGHT OR OBESE New MDPH Study Finds Obesity Increasing

Growing Concerns about Obesity Among Adults in Massachusetts: A Statistical Analysis of BRFSS Data Health Survey Program Division of Research and Epidemiology Bureau of Health Statistics, Research, and Evaluation Massachusetts Department of Public Health July 2002

Overweight and obesity may not be infectious diseases, but they have reached epidemic proportion in the United States. Overweight and obesity are increasing in both genders and among all population groups. - David Satcher former U.S. Surgeon General

Morbidity Associated with Obesity heart disease type 2 diabetes hypertension elevated incidence of joint and mobility problems some types of cancer

What is the BRFSS? °Random-digit-dial telephone survey °Adults ages 18 and older °Joint collaboration between CDC and State Departments of Health °Massachusetts BRFSS since 1986 °Data are weighted: provide population-based estimates of health °N = 8,149 (year 2000)

BRFSS TOBACCO CANCER CONTROL DRUG & ALCOHOL SEXUAL BEHAVIOR DOMESTIC VIOLENCE BLOOD PRESSURE AND CHOLESTEROL NUTRITION AND EXERCISE ORAL HEALTH HEALTH CARE ACCESS OSTEOPOROSIS HEIGHT, WEIGHT, WEIGHT CONTROL

How is obesity measured in adults? Self report on height and weight Body Mass Index (BMI): a measure of weight in relation to height = weight (kg) / height (m) 2 Classification: Underweight: BMI < 18.5 Overweight: BMI Obese: BMI > 30.0 Note: classification of children is different

Overweight Obese Height BMI BMI > 30 5’128 lbs.153 lbs. 5’2’’ ’4’’ ’6’’ ’8’’ ’ Overweight and Obese by Height

Overweight Obese Height BMI BMI > 30 5’128 lbs.153 lbs. 5’2’’ ’4’’ ’6’’ ’8’’ ’ Overweight and Obese by Height

Percentage Overweight/Obese and Obese by Sex, Massachusetts Adults BRFSS 2000

Percentage Overweight/Obese by Sex and Race, Massachusetts Adults, BRFSS 2000

Percentage Obese by Sex and Race, Massachusetts Adults, BRFSS 2000

Percentage Overweight/Obese and Obese by Age, Massachusetts Adults, BRFSS 2000 Overweight/obese Obese Age

Percentage Obese by Education and Income, Massachusetts Adults, BRFSS 2000

Percentage Obese by Region, Massachusetts Adults, BRFSS 2000

Percentage Overweight/Obese by Fruit and Vegetable Consumption, Massachusetts Adults, BRFSS 2000 menwomen

Percentage Overweight/Obese and Obese by Regular Physical Activity, Massachusetts Adults, BRFSS 2000 menwomen

Percentage Overweight/Obese by Smoking Status, Massachusetts Adults BRFSS 2000

Percentage Overweight/Obese by Marital Status and Sex, Massachusetts Adults, BRFSS 2000

Percentage Overweight/Obese by Presence of Children in Household, Massachusetts Adults, BRFSS 2000 menwomen

Prevalence of Diabetes among Overweight/Obese, Massachusetts, Adults BRFSS 2000

Prevalence of CHD/Angina among Overweight/Obese Adults age 40+, Massachusetts, BRFSS 2000

Trends for Overweight for US and Massachusetts,

How is Massachusetts Doing? Rank: 1=Best, 50=Worst

Summary of Adult Data Current obesity epidemic in Massachusetts mirrors national trends groups at greater risk include: –persons with low income or education –certain racial ethnic groups –more sedentary adults BRFSS data should be used to inform policy and develop prevention and treatment approaches

Growing Concerns about Obesity in Massachusetts during Pregnancy and Early Childhood: A Statistical Analysis of WIC PNSS and PedNSS Data Bureau of Family and Community Health, Massachusetts Department of Public Health July 23, 2002

Massachusetts WIC Program Preventive nutrition program with benefits that include supplemental nutritious foods, nutrition education, and referrals to health care Pregnant or postpartum women, infants, and children up to age 5 who are at "nutritional risk" and meet income guidelines are eligible Massachusetts WIC Program annually serves approx. 33,000 women, and 120,000 infants and children, using federal and state funds

Goals of PNSS and PedNSS Pregnancy Nutrition Surveillance System (PNSS, present)  To monitor behavioral and nutritional risk factors among moderate- to low-income U.S. pregnant & postpartum women participating in public health programs Pediatric Nutrition Surveillance System (PedNSS, present)  To monitor the general health and nutritional status of moderate- to low-income U.S. children served by public health programs

Nutrition Surveillance Data Components PedNSS  Demographics  HT & WT  Hgb or Hct  Birthweight  Infant feeding (<24 months) PNSS  Demographics  Pre-pregnancy WT  Pregnancy WT gain  Hgb or Hct  Smoking and Alcohol use  Medical care  Infant feeding

Massachusetts WIC/PNSS Demographic Characteristics Age: 20% age < 20 54% age % age >= 30 Race/Hispanic Ethnicity: 50% White non-Hispanic 18% Black non-Hispanic 25% Hispanic 6% Asian Education: 22% < 12 y completed 71% >= 12 y completed 7% unknown

Race/Hispanic ethnicity among MA WIC participants compared to MA statewide birth data 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=33,176); Massachusetts Births 1999, MDPH, 2001 (n=80,866)

Pre-pregnancy weight status 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=26,856) 42.6% combined

Pre-pregnancy weight status by maternal age 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=26,855)

Pre-pregnancy weight status by race/Hispanic ethnicity 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=26,856)

Pre-pregnancy weight status by parity 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=25,883)

Source: Massachusetts WIC Program, 1999 (n=22,876) Weight gain status during pregnancy 1999 MA WIC/PNSS

Weight gain status during pregnancy by parity 1999 MA WIC/PNSS Source: Massachusetts WIC Program, 1999 (n=25,094)

Pediatric Nutrition Surveillance System (PedNSS) Short Stature height-for-age < 5th percentile 1 Underweight weight-for-age < 5th percentile Risk for Overweight 85th percentile < weight-for-height 2 < 95th percentile Overweight >= 95th percentile weight-for-height Anemia 1 All percentiles given are relative to the 2000 CDC growth chart reference 2 Substituted here for BMI-for-age; both measures are interchangeable in this age range

A Note about Terminology... Terminology for roughly equivalent categories is different in children than in adults. The term “obesity” is not recommended for use when describing children. The term “overweight” reflects a different category in children than in adults.

PedNSS Demographic Characteristics

Source: Massachusetts WIC Program, 2001 (n= 117,270). Prevalence of short stature by age 2001 MA WIC/PedNSS

Prevalence of underweight by age 2001 MA WIC/PedNSS Source: Massachusetts WIC Program, 2001 (n= 117,423).

Prevalence of risk for overweight and overweight by age 2001 MA WIC/PedNSS Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old. 33.5% 32.0%

Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old. 29.9%32.7%38.7%25.3% Prevalence of risk for overweight and overweight by race/Hispanic ethnicity 2001 MA WIC/PedNSS

Prevalence of risk for overweight and overweight: Massachusetts PedNSS compared to National PedNSS 2001 MA WIC/PedNSS Source: Massachusetts WIC Program, 2001 (n= 55,896). Children >= 2 years old. 33%28%

Key Findings PNSS: 43% of women were either overweight or obese prior to their current pregnancy 51% of women gained more than the recommended amount of weight during pregnancy PedNSS: More than one-third of children aged 2-5 were either at risk or already overweight Prevalence of risk for overweight and overweight was high among all ethnic groups; although the prevalence was lowest among Asian children, it approached that found among other ethnic groups